The Wuhan-on-the-Hudson fiasco continues to unfold. They have all of the economic suffering of economic and societal shutdown and all of the exponential growth that was seen in countries that made no effort to “flatten the curve” (ft.com shows New York state actually growing faster than Lombardy during comparable weeks!).
My friends who work in health care there say that some hospitals are fairly quiet while others, just a mile or two away, are packed. There is no mechanism for sending patients who can wait a couple of hours for care to upstate hospitals that are more or less empty, nor even a mechanism for balancing the load among hospitals within New York City. (Let’s not even talk about New Jersey; they’re just as overwhelmed as NYC, but nobody in American media cares if someone in New Jersey dies, even if it is from COVID-19.)
The New York Department of Health has a $88 billion annual budget (see page 45; it is a bit confusing because in some years the “annual budget” really includes two years of Medicaid; you could also say that the real budget is closer to $94 billion because they moved mental health and “addiction services” out). This is partly for public health functions, such as the ones that left the state without any preparations for a flu or flu-like outbreak, and mostly to pay for unlimited procedures to be applied to those with low-income or no income (Medicaid; New York funds a lot of stuff that other states won’t fund and, correspondingly, had less money available for public health).
How much is $88 billion? Mexico spends about $1050 per person on health care. That includes health care for the rich, middle class, and poor. Mexico’s population is roughly 130 million so this works out to about $136 billion. In other words, with only 20 million people, New York spends close to as much on public health and welfare health insurance as Mexico does to care for its entire population, including cosmetic surgery for the richest people in Polanco. (How are the results in the Mexican system? Mexican life expectancy is about one year less than American life expectancy.)
Comparisons between coronavirus and war are common. What if we wanted to have a military force with supersonic fighter jets, nuclear-powered submarines, an aircraft carrier, nuclear weapons, ballistic missiles, nearly 1 million active-duty troops, and 2 million reservists? Somewhere around $70 billion is what Russia spends. In other words, New York state spends more for public health and welfare health care than Russia spends to fund what might be the world’s most powerful military (let’s hope that we never find out who is actually the strongest!).
- Suppose that everyone with COVID-19 got a ventilator: “What You Should Know Before You Need a Ventilator” (NYT, by a physician)
- Same newspaper, same day, but by a journalist: “‘Code Blue’: A Brooklyn I.C.U. Fights for Each Life in a Coronavirus Surge” (mostly contradicts the above and implies that an application of massive quantities of medical personnel and machines can save the typical patient seriously afflicted with COVID-19)
- Medicaid spending by state (most recent data is from FY2014; California was spending $4,200/year on a Medicaid enrollee. New York was spending $7,800)
- “Transgender programs flourish following New York Medicaid coverage” (New York taxpayers will fund a gender transition every year (or every month) for those who don’t work)
- NYS Infertility Demonstration Program: “The program subsidizes higher level infertility treatments in vitro fertilization (IVF) and gamete intra fallopian transfer (GIFT) for privately insured women for whom these procedures are not covered by insurance.” (Let’s most ignore the transgender exclusionary language (“women”) here, but remind readers that some men need IVF too!) If you struggle to make ends meet without subsidies, New York taxpayers will pay to generate some additional likely welfare recipients via IVF
21 thoughts on “New York state public and welfare health spending compared to Russia’s military budget”
2 million reservist number for Russia is incorrect. Almost all males age 18-45 are in reserve, ie it should be in 10s of millions.
Every Russian male is in reserve in the sense that he has to report if Hitler invades Russia (Syria or Donetsk don’t qualify), but amid my big-city-dwelling, college educated friends only one knows how to disassemble an AK. Russian reserves are like Pierre Bezukhov: “Explain me where and how to stroll and where to shoot”. (As opposed to e.g. Swiss or Azerbaijani reserves).
Not sure whether the situation with conscription in Russia (всеобщая воинская обязанность) is any different now in comparison to what it was during the Soviet Union times. According to the pretty decent Wikipedia article, draft avoidance is still a felony in Russia.
During the Soviet times, the saying was that draft was as unavoidable as death. The majority of 18 year olds were conscripted for 2 years to serve in the Army or 3 years in the Navy. There were exceptions of course for health reasons or deferments for college students who had to serve one or two years upon graduation as a private or an NCO if their college had a military department.
As to the AK-47, every schoolboy in the secondary school tenth grade went through a so called “initial military training class” where they were taught how to disassemble/reassemble/clean the weapon. Your Pierre Bezukhov analogy is beside the point, therefore.
So, either your acquaintances selection is not representative of the general Russian population, or the situation in the modern Russia is dramatically different from what had been before 1993.
An article referenced from the English-language Conscription in Russia page said back in 2002 that “Only 11 percent of Russian men enter mandatory military service”. The Russian-language version says in 2014 the penalty was basically a $300 fine.
> There is no mechanism for sending patients who can wait a couple of hours for care to upstate hospitals that are more or less empty, nor even a mechanism for balancing the load among hospitals within New York City.
Astonishing that after all this time post-9/11 there is apparently no functional contingency plan for sharing the load among hospitals in response to a disaster. At least not any that someone can point to a three-ring binder and publish on the news. But I’m not surprised. For all the media coverage over the arrival of the Comfort hospital ship, Cuomo’s presser, de Blasio’s presser, the crowd gathering to watch it arrive and all the ballyhoo, the last I read there were just 20 patients on it. It is not allowed to accept COVID-19 patients or people with 49 other conditions, according to the last article I read. Miles of red tape and regulations, so it is doing virtually nothing to relieve the burden on the overcrowded facilities in NYC.
““It’s a joke,” said a top hospital executive, whose facilities are packed with coronavirus patients.”
“On top of its strict rules preventing people infected with the virus from coming on board, the Navy is also refusing to treat a host of other conditions. Guidelines disseminated to hospitals included a list of 49 medical conditions that would exclude a patient from admittance to the ship.”
A little bit later, USNI indiciated that some COVID-19 patients had been “accidentally” transferred to the ship and well, you can read the rest. Of course, if they transfer more COVID patients there, what you have in that instance is another big ship full of sick people…except not in individual cabins, they’re stacked in bunks.
““It’s not an environment built for handling infectious diseases,” he said. “So our concerns are a couple: One, keeping the spread from non-COVID infected patients on the ship. That would be very difficult. Two, our expectation has always been that these Comfort and the Mercy would go to the areas of greatest need, and then as the wave passes… that maybe the Comfort and the Mercy are needed somewhere else. Maybe they are needed in Miami or New Orleans or somewhere else on the East Coast, and maybe the Mercy is needed somewhere else.”
Of course, knowing that both the Comfort and its sister ship Mercy were built to handle combat casualties and not intended or outfitted to combat infectious disease epidemics might have prompted an dumb observer to question why they were being deployed in this capacity at all. Particularly given the spread of the virus in hospitals needing relief, and the inability to rapidly test people, how did anyone reasonably think they would be able to keep COVID-19 patients off the ships? And in any case, once the ship is “contaminated” – then what? Take it out of service until the staff can be replaced and the ship completely sanitized?
Why would independent hospitals spend any resources to co-ordinate and plan for once-in-a-lifetime events? That would eat into shareholder profits. It’s as crazy as McDonald’s sending folks to Burger King if they get busy. Capitalism doesn’t do emergencies. Just wait for the insurance company defaults. Capitalism = privatized profits and socialized risk.
Senorpablo: What is “capitalist” about the New York Department of Health? The hospitals that they fund with tax dollars via Medicaid are regulated by the Feds and the state and have to do whatever the regulators tell them to do, right? Separately, what is the relevance of the for-profit hospital behavior that you’re conjecturing? There are no shareholders in 86 percent of New York’s hospitals because they are nonprofit. https://www.beckershospitalreview.com/finance/report-for-profit-hospital-model-one-way-new-york-hospitals-can-improve-financially.html
I think you’re saying that when the state uses tax dollars to pay a regulated nonprofit hospital to care for someone who doesn’t work… that’s “capitalism”!
Does it matter if the hospitals in one locale are non-profit or government funded? Presumably, one of the highest expenses is personnel, of which they are competing against the private hospitals, and other states which have higher percentages of private hospitals and lower cost of living.
The clearest example of the corruption and incompetence endemic to NYC is the extension to the NYC subway system that cost $3.5 billion per mile — way in excess of the cost of this sort of work anywhere else in the world. This was well documented by the NYT & criminal cases should have been brought but never were: https://www.nytimes.com/2017/12/28/nyregion/new-york-subway-construction-costs.html
The Attorney General rather than investigating this obvious corruption instead decided to sue Exxon for global warming, a case a NY judge dismissed as total nonsense. Government officials pay off the municipal workers and other interests and get to keep their jobs. The more incompetent and lazy the public official the better it is for the municipal unions since no one is paying attention That is the way NYC works. The governor now runs the city because the mayor is too incompetent and lazy & the Governor has nothing else to do since the left eviscerated upstate NY with high minimum wages and all kinds of other nonsense — so upstate NY looks like Appalachia, check out Poughkeepsie, once a leading US industrial city, now a empty town overgrown with weeds. A Christian aid group built a hospital in Central Park and the Mayor rather than being thankful is criticizing them because of their supposed views on homosexuality — and has said he is “monitoring the situation” — the situation concerning him being their views on sexuality rather than the free help they are giving he city. Go figure.
I have long believed NY State government (and many state governments as well as the Fed govt,) has been robbing us blind to the tune of trillions over the last few decades, I think Trump and others are investigating this while we sit at home.
Hope I am not wrong.
Not precisely on-topic, but it is in New York, and it caught my eye because the animal was tested so quickly, and because it *tested positive*. A tiger has apparently caught the virus at the Bronx Zoo.
So, somehow the virus can infect them, too. How many more animal species can carry it and are they contagious, too? Are we going to have to flatten the curve with animals, too?
Lolz. If test kits are so precious why test a tiger? They should test my toaster it’s been running a fever. How far can they push the narrative before no one believes any of it?
(There’s no way to Answer in the thread).
Ivan, the draft system has changed drastically since the soviet time. De facto. De jure it’s the same, except the term is shorter now. I was 10 y.o. in the 1993, and don’t remember what it was like, but in ~1998 and after the only people serving the draft were either extremely unfortunate or those, that thought of the army as of a social lift, i.e. even more unfortunate. For any urban Russian younger than ~40-something avoiding draft was extremely easy, through bogus diagnosis or admission to higher education. When I graduated HS, in 1999, either would have cost you about $500.
It’s a bit of a speculation, but I believe the first Chechen war really draw the line. No one of my school acquaintances in Moscow even considered a possibility of going to the army.
Recently (after 2007) we have witnessed a ressentiment (they play the national anthem before the classes in school now!) which have probably shifted public attitude a little, but all people I know (40-) that have actually been drafted are Summer village buddies, except for one.
I corroborate fully your soviet time assessment. My boomer, buddhistic father knows how AK works, and I have no idea, beside vague 9-grade physics.
I see. Thanks for sharing !
PS: As for military education in school, we had a person formally assigned to the work (“военрук”), and I knew what he looked like, but for some reason we didn’t ever have actual classes of “military preparedness”. He was considered a bomb-shelter administrator, and was silently drinking vodka every day from 9AM
Medicaid recipents are NOT eligible for in vitro fertilization in New York. New York’s fertility mandate only affects private insurance of companies with 100+ employees. Per the NY Post article:
“Who isn’t eligible under this new law?”
“Anyone on Medicaid, employees of small and medium-sized companies of less than 100 employees, companies that self-insure and those with individual insurance plans.”
The law mandates 3 cycles of treatment, estimated at 25K per cycle.
I am noticing ‘freeze your eggs’ advertisements on local bus shelters. They are dual-language: chinese and english.
Coronavirus messages on the city’s electronic street and subway billboards are in chinese, spanish and english. Different advice is given in different languages and different venues. English speakers are advised streetside to stay home if they get sick and to contact a doctor if things worsen after four or five days. Spanish speakers on the subway are advised to seek medical attention immediately if they feel unwell. I have no idea what the chinese are being told.
Oops. Thanks for the correction. I had searched for “Medicaid IVF New York” and just skimmed, apparently.
I updated the original post. It turns out that there actually IS welfare (handouts of taxpayer funds) for IVF in New York State. It doesn’t come through Medicaid, though.
Interesting on the difference between English and Spanish! Maybe we can’t take the risk of losing any Spanish speakers now that we will all want to flee to Mexico, Honduras, El Salvador, Nicaragua, et al.!
I thought this comparison of the NYC-centered outbreak to the California outbreak was interesting. Why isn’t California’s coronavirus crisis as bad as New York’s? Size doesn’t tell the whole story. “Density, decisive action and luck are all factors in why the West Coast’s outbreaks are less terrifying than the East’s so far.”
Are you surprised because you actually thought you had a working health care system? Most Russians knew that Pravda was not actually the truth. It seems to me americans are unable to understand that the same holds for your modern, televised Pravda.
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